An apple or a pear? Nutritionally speaking, both are equally good but metabolically, the apple and the pear shapes spell significant differences. Individuals (men or women) gain weight in different locations. Some gain more weight around the abdomen and waist, which is the “male patterned”obesity. This type of obesity, which makes you look like an apple, is called abdominal, android or central type. Another pattern of weight gain (men or women) is excessive weight around the hips and thighs, the female pattern. This type of obesity is called a gynoid type and the body shape resembles a pear. Apple-shaped individuals are far more at risk of developing diabetes, high blood pressure, coronary artery disease and have a tendency to get abnormal lipids and blood clotting. This is perhaps because abdominal fat is in closer proximity to the liver. This alters the functioning of the hormone insulin making a person resistant to insulin. Android obesity may also indicate an increased breast cancer risk for women. When abdominal fat was measured with a special technique called DEXA (Dual Energy X-ray Absorptiometry) scan in both obese and lean individuals, it was the intra-abdominal fat that showed stronger correlation with insulin resistance than did the overall obesity. The greater the proportion of abdominal fat, the greater is the risk for chronic degenerative diseases. Abdominal obesity stimulates insulin resistance, which in turn promotes weight gain. This also means that even if your BMI (Body mass index) ranges within normal and you have excessive fat around your belly, you can be insulin-resistant and “at risk”for developing related problems. Most obese people are to some degree insulin-resistant. Those with abdominal obesity are more so. The limitation of BMI is that it does not distinguish between the patterns of obesity. Therefore, another measure used to assess fitness levels is the waist measurement or waist-to-hip ratio. The waist normally refers to the thinnest part on the trunk but for this measurement, it is measured at the maximum part of the trunk. Waist circumference is an approximate index of intra-abdominal fat mass and total body fat. Furthermore, changes in waist circumference reflect changes in risk factors for cardiovascular disease and other forms of chronic diseases. A measurement of less than 80 cm for women and less than 90 cm for men is considered acceptable for Asians. A waist to hip ratio of greater than 0.85 in women or greater than 0.9 in men reflects abdominal obesity. The simplest way to determine your pattern is to look in the mirror. If you have a large belly, not much on the hips and thin extremities, you are likely to be an apple. While genes are very important in determining this pattern, over the past half a century increased sedentary lifestyle and unlimited access to calories have made insulin resistance and abdominal obesity into an epidemic. Lifestyle changes including a low-fat diet with restriction of added sugars and refined carbohydrates and regular aerobic exercise for at least an hour can correct your shape, check your BMI and save you many problems in the future.The writer is a former senior nutritionist at Escorts. She heads the Centre of Dietary Counselling and also runs a health food store. She feels that for complete well-being, one should integrate physical, mental and spiritual health. According to her: “To be healthy should be the ultimate goal for all.”
